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Dorca E, Velasco A, Varela M, Gatius S, Villatoro S, Fullana N, Cuevas D, Vaquero M, Birnbaum A, Neumann K, Matias-Guiu X. Validation of Modaplex POLE mutation assay in endometrial carcinoma. Virchows Arch 2023; 483:787-794. [PMID: 37874375 DOI: 10.1007/s00428-023-03636-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/11/2023] [Accepted: 08/24/2023] [Indexed: 10/25/2023]
Abstract
The TCGA-based molecular classification of endometrial cancer has emerged as an important tool to stratify patients according to prognosis. A simplified scheme has been proposed, by using immunohistochemistry for p53, MSH6, and PMS2 and a molecular test for POLE mutations (NGS or Sanger sequencing, techniques that are not available in many centers worldwide). In this study, we validate a novel method that allows simultaneous analysis of multiple pathogenic POLE mutations. The Modaplex technology integrates polymerase chain reaction and capillary electrophoresis. The design of this study encompassed 4 different steps: (1) a retrospective-pilot phase, with 80 tumors, balancing the four molecular subgroups. (2) A retrospective phase of 25 tumors obtained between 2016 and 2020, and 30 tumors obtained between 2000 and 2015. (3) An inter-laboratory corssavalidation step with 19 cases (belonging to phases 1 and 2). (4) A prospective cohort of 123 tumors, of unknown POLE status, with simultaneous validation by Sanger sequencing. A total of 258 samples were analyzed. In the first and second phases, the test showed positive/negative predictive values of 100%, by correctly identifying POLE mutation status in 79/79 and 55/55 cases. Phase 3 showed 100% of inter-laboratory consistency. Phase 4 showed 16 positive samples out of the 123 prospective cases. Overall, the test has revealed sensitivity and specificity of 100%, identifying a total of 47 POLE-mutated tumors. We have shown that this technique allows faster and easier identification of multiple pathogenic POLE mutations with high robustness and confidence when comparing to other tests such as Sanger sequencing.
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Affiliation(s)
- Eduard Dorca
- Pathology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Ana Velasco
- Pathology Department, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, CIBERONC, Av Rovira Roure 80, 25198, Lleida, Spain
| | - Mar Varela
- Pathology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Sonia Gatius
- Pathology Department, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, CIBERONC, Av Rovira Roure 80, 25198, Lleida, Spain
| | - Sergio Villatoro
- Pathology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Neus Fullana
- Pathology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Dolors Cuevas
- Pathology Department, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, CIBERONC, Av Rovira Roure 80, 25198, Lleida, Spain
| | - Marta Vaquero
- Pathology Department, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, CIBERONC, Av Rovira Roure 80, 25198, Lleida, Spain
| | - Astrid Birnbaum
- Städtisches Klinikum Dessau Institut für Pathologie, Dessau-Roßlau, Germany
| | - Karsten Neumann
- Städtisches Klinikum Dessau Institut für Pathologie, Dessau-Roßlau, Germany
| | - Xavier Matias-Guiu
- Pathology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain.
- Pathology Department, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, CIBERONC, Av Rovira Roure 80, 25198, Lleida, Spain.
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Bando Y, Kobayashi T, Miyakami Y, Sumida S, Kakimoto T, Saijo Y, Uehara H. Triple-negative breast cancer and basal-like subtype : Pathology and targeted therapy. THE JOURNAL OF MEDICAL INVESTIGATION 2021; 68:213-219. [PMID: 34759133 DOI: 10.2152/jmi.68.213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Triple-negative breast cancer (TNBC) is a heterogenous disease. For personalized medicine, it is essential to identify and classify tumor subtypes to develop effective therapeutic strategies. Although gene expression profiling has identified several TNBC subtypes, classification of these tumors remains complex. Most TNBCs exhibit an aggressive phenotype, but some rare types have a favorable clinical course. In this review, we summarize the classification and characteristics related to the various TNBC subtypes, including the rare types. Therapeutic methods that are suitable for each subtype are also discussed. Of the intrinsic breast cancer subtypes identified by gene expression analysis, the basal-like subtype specifically displayed decreased expression of an estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) cluster. We also present results that characterize the TNBC and basal-like phenotypes. TNBC may be categorized into four major classes : basal-like, immune-enriched, mesenchymal, and luminal androgen receptor. Therapeutic strategies for each subtype have been proposed along with newly approved targeted therapies for TNBC, such as immune checkpoint inhibitors. Understanding the classification of TNBC based on gene expression profiling in association with clinicopathological factors will facilitate accurate pathological diagnosis and effective treatment selection. J. Med. Invest. 68 : 213-219, August, 2021.
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Affiliation(s)
- Yoshimi Bando
- Division of Pathology, Tokushima University Hospital, Tokushima, Japan
| | - Tomoko Kobayashi
- Division of Pathology, Tokushima University Hospital, Tokushima, Japan
| | - Yuko Miyakami
- Division of Pathology, Tokushima University Hospital, Tokushima, Japan
| | - Satoshi Sumida
- Division of Pathology, Tokushima University Hospital, Tokushima, Japan
| | - Takumi Kakimoto
- Division of Pathology, Tokushima University Hospital, Tokushima, Japan
| | - Yasuyo Saijo
- Department of Molecular Pathology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hisanor Uehara
- Division of Pathology, Tokushima University Hospital, Tokushima, Japan
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Akagi K, Oki E, Taniguchi H, Nakatani K, Aoki D, Kuwata T, Yoshino T. Real-world data on microsatellite instability status in various unresectable or metastatic solid tumors. Cancer Sci 2021; 112:1105-1113. [PMID: 33403729 PMCID: PMC7935787 DOI: 10.1111/cas.14798] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 01/07/2021] [Accepted: 01/07/2021] [Indexed: 12/23/2022] Open
Abstract
Microsatellite instability‐high (MSI‐H) is an important biomarker for predicting the effect of immune checkpoint inhibitors (ICIs) on advanced solid tumors. Microsatellite instability‐high is detected in various cancers, but its frequency varies by cancer type and stage. Therefore, precise frequency is required to plan ICI therapy. In this study, the results of MSI tests actually carried out in clinical practice were investigated. In total, 26 469 samples of various cancers were examined between December 2018 and November 2019 to determine whether programmed cell death‐1 blockade was indicated. The results of MSI tests were obtained for 26 237 (99.1%) of these samples. The male : female ratio was 51:49 and mean age was 64.3 years. In all samples, the overall frequency of MSI‐H was 3.72%. By gender, the frequency of MSI‐H was higher in female patients (4.75%) than in male patients (2.62%; P < .001). A comparison by age revealed that the frequency of MSI‐H was significantly higher in patients younger than 40 years of age (6.12%) and 80 years or older (5.77%) than in patients aged between 60 and 79 years (3.09%; P < .001). Microsatellite instability‐high was detected in 30 cancer types. Common cancer types were: endometrial cancer, 16.85%; small intestinal cancer, 8.63%; gastric cancer, 6.74%; duodenal cancer, 5.60%; and colorectal cancer, 3.78%. Microsatellite instability‐high was detected in cancer derived from a wide variety of organs. The frequency of MSI‐H varied by cancer type and onset age. These data should prove especially useful when considering ICI treatment.
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Affiliation(s)
- Kiwamu Akagi
- Department of Molecular Diagnosis and Cancer Prevention, Saitama Cancer Center, Saitama, Japan
| | - Eiji Oki
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Hiroya Taniguchi
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kaname Nakatani
- Department of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Tsu, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Takeshi Kuwata
- Department of Genetic Medicine and Services, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takayuki Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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